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Tofacitinib, marketed as Xeljanz, carries several important safety warnings that should be carefully considered before and during treatment. It is essential to discuss these risks with your healthcare provider to ensure safe use.

• Infection Risk: Tofacitinib may impair your immune system's ability to combat infections, increasing the likelihood of severe infections such as pneumonia, shingles, and urinary tract infections. This risk is heightened if you are taking other immunosuppressive drugs. Symptoms to watch for include persistent sore throat, fever, chills, cough, difficult or painful urination, and non-healing skin sores. A tuberculosis (TB) skin test is required before and during treatment, especially if you have been in areas where TB or fungal infections are prevalent.

• Cancer Risk: There is a potential risk of developing cancers like lymphoma, lung cancer, and skin cancer during treatment. This risk may be higher for individuals with a history of smoking. Notify your doctor if you experience persistent fever, cough, unusual growths, weight loss, night sweats, or changes in skin appearance.

• Blood Clots and Cardiovascular Risks: Tofacitinib may elevate the risk of blood clots, heart attacks, and strokes, particularly in patients aged 50 and older with risk factors for heart disease. Immediate medical attention is needed for symptoms such as shortness of breath, chest pain, sudden dizziness, severe headaches, or unilateral weakness.

• Stomach Issues: Some patients have reported gastrointestinal tears, especially those with a history of diverticulitis or taking NSAIDs. Seek medical help if you experience severe abdominal pain or notice blood in your stool.

• Allergic Reactions: Though rare, severe allergic reactions are possible. Symptoms include facial or throat swelling, breathing difficulties, and rash. Urgent medical attention is required if these occur.

• Blood Cell Count Changes: Treatment may lower red and white blood cell counts, increasing the risk of anemia and infection. Regular blood tests are necessary, and symptoms such as fatigue, pale skin, or persistent infections should be reported to your provider.

• Liver Damage: Elevated liver enzyme levels can indicate liver damage. Regular liver function tests are recommended, and symptoms such as nausea, stomach pain, or jaundice should be reported immediately.

These warnings underscore the importance of routine monitoring and open communication with your healthcare provider while taking tofacitinib.

When taking this medication, you might experience some common side effects. These include upper respiratory tract infections, nose and throat infections, diarrhea, and headaches. These effects are usually mild and may subside on their own. However, if they persist or worsen, consulting a healthcare provider is advisable.

Some users have also reported other side effects such as high cholesterol, muscle damage, rashes, stomach infections, and anemia. These symptoms can vary in severity, so it's important to monitor your condition and seek medical advice if necessary, especially if the symptoms are severe.

There are rare but serious side effects that require immediate medical attention. These include unusual tiredness, fast heartbeat, signs of liver disease like persistent nausea, loss of appetite, stomach pain, yellowing of the skin or eyes, and dark urine. Allergic reactions, while uncommon, can occur and may present as a rash, itching, swelling of the face, tongue, or throat, severe dizziness, and difficulty breathing. In such cases, it is crucial to seek urgent medical care to prevent complications.

Tofacitinib, marketed as Xeljanz, can interact with various medications, potentially altering its effectiveness or increasing the risk of side effects. It is important to inform your doctor and pharmacist about all medications and supplements you are taking, including over-the-counter drugs and herbal products.

Certain medications, such as rifampin and St John's Wort, can affect how tofacitinib is processed in your body. Additionally, combining tofacitinib with drugs like abatacept, adalimumab, carbamazepine, cyclosporine, and many others may not be advisable unless specifically directed by your healthcare provider. In some cases, they might need to adjust your dosage or frequency of use to manage potential interactions.

Furthermore, using tofacitinib with fluconazole may increase the likelihood of side effects, so your doctor may modify your treatment plan if both are needed. Always consult your healthcare provider before making any changes to your medication regimen.